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At least 1,495 records · Page 83Linked to original sources
PubMed2000

Major lower extremity amputation in Veterans Affairs medical centers.

Our objective was to assess outcomes for 8696 patients who underwent 9236 above- (AKA) and/or below-knee (BKA) amputations during a 4-year period for disorders of the circulatory system. Veterans Affairs (VA) Patient Treatment File (PTF) data were acquired for all patients in Diagnosis Related Groups (DRGs) 113 and 114 hospitalized in VA medical centers (VAMCs) during fiscal years 1991-1994. Data were further analyzed by Patient Management Category (PMC) software, which measured illness severity, patient complexity, and relative intensity score (RIS), a measure of resource utilization. The results of this analysis showed that mortality and morbidity rates remain high after AKA and BKA. Differing amputation practice patterns found in this study warrant further investigation.

Adult↗
PubMed2006

Racial differences in clinical progression among Medicare recipients after treatment for localized prostate cancer (United States).

OBJECTIVE: Prostate cancer recurrence impacts patient quality of life and risk of prostate-cancer specific death following definitive treatment. We investigate differences in disease-free survival among white, black, Hispanic, and Asian patients in a large, population-based database. METHODS: Merged Surveillance, Epidemiology, and End Results Program (SEER) and Medicare files provided data on 23,353 white patients, 2,814 black patients, 480 Hispanic patients, and 566 Asian patients diagnosed at age 65-84 years with clinically localized prostate cancer between 1986 and 1996 in five SEER sites. Patients were followed through 1998. Racial differences in disease-free survival were assessed using Kaplan-Meier survival curves and Cox regression models. RESULTS: The 75th percentile disease-free survival time for black patients was 13 months less than that for white patients (95% confidence interval [CI]: 6.2-19.8 months), 29.7 months less than that for Hispanic patients (95% CI: 4.4-55.0 months), and 39.1 months less than that for Asian patients (95% CI: 12.1-66.1 months). In multivariate analysis, black race predicted shorter disease-free survival among surgery patients, but not among radiation patients. CONCLUSIONS: Black patients experienced shorter disease-free survival compared to white, Hispanic, and Asian patients, and the disease-free survival of white, Hispanic, and Asian patients were not statistically different. Earlier recurrence of prostate cancer may help explain black patients' increased risk of mortality from prostate cancer.

Black or African American↗
PubMed2006

Simultaneous collection of rapid chlorophyll fluorescence induction kinetics, fluorescence quenching parameters, and environmental data using an automated PAM-2000/CR10X data logging system.

The PAM-2000 portable chlorophyll fluorometer represents one of the first commercially available instruments utilizing the Pulse Amplitude Modulation (PAM) measurement principle, and has become a widely used platform for measuring chlorophyll fluorescence in a wide range of study systems. In this paper, we describe a new method for externally driving and gathering data from the PAM-2000, a method that allows the user to execute a pre-defined user run (or runs) and capture (1) rapid induction kinetics (at 2 ms frequency) during all saturating pulses, (2) measures of F, F(o), F(o)', F(m), and F(m)' associated with those same pulses, and (3) changes in fluorescence F at user-defined intervals between pulses, for the entire user run, with all data compressed into a single, manageable data logger file. Practically, the method makes possible, for example, a post-hoc evaluation of the appropriateness of saturation pulse lengths and intensities during a user run. More importantly it captures, during entire user runs, the varied information contained in slow changes in fluorescence between saturating pulses, as well as rapid induction kinetics, quenching coefficients and quantum yields all gathered simultaneously from all saturating flashes.

Automation↗
PubMed1979

Activity and work during pregnancy and the postpartum period: a cross-cultural study of 202 societies.

Cross-cultural information on 202 traditional societies was perused for data on customs surrounding the expected work load of pregnant and postpartum women. The most common single pattern of work activity during pregnancy was that of continuing full duties until the onset of labor. A bare majority of societies did encourage a lightening of work at some time during pregnancy. Postnatally, most societies did restrict maternal work activity; however, few suspended usual work duties for prolonged periods of time. About one half of societies expected a return to full duties within 2 weeks. Results suggest that the current American trend toward increased participation of women of childbearing age in the work force may be in keeping with the work loads of women in traditional societies.

Attitude↗
PubMed1995

Intermenstrual affect in women with symptomatic premenstrual change.

To determine whether women seeking treatment for symptomatic premenstrual change have ongoing psychological disturbance, we undertook a cross-sectional, comparative study across four groups of reproductive-age women. Subjects were 35 patients with symptomatic premenstrual change and no psychiatric history, 35 women without symptomatic premenstrual change, 35 patients with affective disorders, and 35 women from the community at large. All women except those in the community sample were tested in the intermenstrual phase (after menses but before the 12th cycle day). Psychological tests administered were Profile of Mood States, State-Trait Anxiety Inventory, Institute for Personality and Ability Testing (IPAT) Anxiety Scale, IPAT Depression Scale, General Health Questionnaire and the Family Inventory of Life Events (FILE). Demographic data and information concerning present and past stresses were also collected. Women with symptomatic premenstrual change were distinguishable from psychiatric patients on assessment of intermenstrual mood state. They were no different from women within the community at large or from non-symptomatic women. When symptomatic women reported on time periods, which include the premenstrual phase of the cycle, we found results at variance with those obtained in relation to current state mood. While not unlike the women from the community at large in longer term affective characteristics, they were consistently different from non-symptomatic women and sometimes indistinguishable from psychiatric patients. Women with symptomatic premenstrual change also reported higher levels of past external stresses than women taken from the community at large.

Adult↗
PubMed1993

A modularized infrared light matrix system with high resolution for measuring animal behaviors.

The current study provides a new modularized infrared light matrix system (about $200 cost) which is designed to measure the horizontal gross or fine movements, vertical motion, clockwise or anticlockwise turnings, freezing time, and total distance traveled in rats. The system records the sequences of animal's activity in a computer-aided system with a resolution of 0.2 s in time or 1.6 cm in space, and permanently stores all the resulting data in file. The behavioral apparatus was tested for its sensitivity and usability by amphetamine-injected rats. It was found that intraperitoneal administration of amphetamine (1.25-2.50 mg/kg), but not normal saline, produced a dose-related increase in either the horizontal gross or fine movements, vertical motion, clockwise or anticlockwise turnings, or total distance traveled. However, amphetamine injections produced a dose-related decrease in freezing time. Apparently, most of the amphetamine-induced responses obtained by other detecting apparatus can be reproduced easily by the present apparatus. The current detection system possesses the following advantages: a) high resolution, b) high expansion potential, and c) precise and simplified algorithms for behavioral parameter analysis.

Algorithms↗
PubMed1983

International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper 5/6. Perspectives in mutation epidemiology, 6. A 1983 view of sentinel phenotypes.

A sentinel phenotype is a clinical disorder or syndrome that (1) occurs sporadically as a consequence of a single, highly penetrant mutant gene, (2) is a dominant or X-linked trait of considerable frequency and low fitness, and (3) is uniformly expressed and accurately diagnosable with minimal effort at or near birth. Although 1828 autosomal dominant traits are known in human beings, 36 can be considered as candidate sentinel phenotypes, along with 5 X-linked disorders. Based on surveys of malformations in infants and children, 16 additional traits are proposed beyond previous lists. In Hungary, the 24 syndromes or defects with reliable manifestations in newborn infants occur with a frequency of 2.5-3.3 per 10 000 live births. As markers of human mutations, sentinel phenotypes have the advantage of representing germinal mutations that result in significant health problems. There are severe disadvantages that have, to date, prevented the launching of a field demonstration of the value of these phenotypes in mutation epidemiology. Agreement on a list of phenotypes has been delayed by continued recognition of two or more distinct genetic diseases within what was once thought to be a single disorder. For the same reason, most of the candidate sentinel phenotypes have not been assigned unique codes in the International Classification of Diseases. Each of the disorders is so rare and has features that overlap with so many other syndromes that highly trained clinical dysmorphologist and pediatric ophthalmologists would have to be engaged in any study. The sentinel phenotype approach, like other strategies in mutation epidemiology, would encounter problems with linkage among files of data, privacy, and access to sufficiently large populations. In contrast with the approach using multiple protein variants (as in the study of blood from offspring of survivors of the atomic bombs in Hiroshima and Nagasaki), the sentinel phenotype approach would likely be much less expensive and would encounter far fewer false attributions of paternity, but also would require a much larger study population. The best option for the present, in our opinion, is to broaden and sustain critical discussion of the approach. Perhaps the goal should be to plan a field demonstration by involving appropriate clinicians, epidemiologists, and public health officials. A pilot effort underway in Hungary may well give insight to applying the approach in a significantly larger population.

Chromosome Aberrations↗
PubMed1985

Automated data acquisition and analysis of neural evoked potentials.

A software system to collect, analyze and store trains of neural evoked potentials is presented. Real-time waveform capture permits sampling of a variable-duration data window of 6 to 399.6 ms with a sample delay accurately adjustable up to 1 001 ms (20 microseconds resolution). The digitized representation of each waveform is stored for individual analysis. Off-line processing determines 17 parameters of each waveform, including an arrow-selected amplitude and time. Individual processing of waveforms preserves all degrees of freedom for statistical analysis across waveforms. Ensemble averages may optionally be formed from the individual waveforms with processing performed on the averaged responses. The software provides MENU-selectable support functions including stimulus-to-artifact timing, storage and retrieval of data and calculated parameters, digital display of waveforms, data calibration and gain modification, table referenced data editing, file management, simple statistics, hardcopy output, and optional database interfacing with output formatted for compatibility with a statistics package (SAS).

Animals↗
PubMed1990

Microcomputer-assisted multivariate survival data analysis using Cox's proportional hazards regression model.

We describe a microcomputer program (COXSURV) for proportional hazards multiple regression analysis of survival and other failure-time data generated in clinical trials and in retrospective clinical epidemiology studies. COXSURV is menu-driven and has powerful variable factoring and data exploratory capabilities for multivariate modeling. A batch mode allows automatic uni- or multivariate analyses for confounder summarization. Model selection for predictive purposes is possible through a step-up algorithm. The partial likelihood method used in the program allows the use of either discrete or continuous time scales by treating tied uncensored observations by either the exact method or by a robust approximation method. The program calculates most standard model fitting statistics for either overall or stratified analyses and uses data layout files compatible with those of other related epidemiologic analysis software.

Algorithms↗
PubMed1995

The antibiotic cost calculator; an expert system for global antibiotic cost calculation.

An application to cost antibiotic therapy was developed using Object Vision, an object-oriented software development program. The application facilitates calculation of the cost of up to six antibiotics (three oral and three intravenous) in terms of acquisition, delivery, laboratory and complication components. The application consists of two files. The first file allows entry of basic cost data. The second file allows the user to define each antibiotic regimen and the management, and thus the cost, of complications relevant to the antibiotics being costed; costs are automatically calculated and displayed. The program also contains a help system; this comprises extensive explanation of each stage of the calculation process, a summary of recent literature on the percentage incidence of complications for commonly used antibiotics, and a bibliography. The summary and bibliography may be printed. The program is designed for use by hospitals, universities and pharmaceutical companies for calculation of total in-patient charges, marketing and research. It is a user-friendly system which dramatically reduces the inherent complexities of this area of medicine.

Anti-Bacterial Agents↗
PubMed1991

HAMOG: molecular graphics program for chemistry, biochemistry, molecular biology and enzyme research.

HAMOG is a computer graphics program written in C for personal computers. Clear menus and a context-sensitive help option make the program easy to operate for occasional users. HAMOG provides a flexible environment for displaying and manipulating molecules and molecular systems. Special functions allow the investigation of structure-activity relationships of biologically active molecules. These include the calculation of molecular electrostatic potentials and fields, the superposition of molecules and the calculation of steric accessibilities. The visualization and manipulation of protein structures immediately readable from the Brookhaven Protein Data Bank files are also possible using HAMOG. The construction of any peptide or protein structure is very simple.

Chemical Phenomena↗
PubMed1992

A crystallographic molecular lattice builder applied to model lipid bilayers.

It is often desirable for noncrystallographers to generate graphical models of three-dimensional crystal structures based on published coordinates of the atoms that make up the crystallographic unit cells. This type of visualization is particularly important for small-molecule crystals, such as lipid crystals, where one may be interested in investigating interactions between the individual molecules in addition to their conformations. BILAYER BUILDER is a program that generates a portion of the entire crystal structure from the coordinates of the molecules in a single unit cell. It gives users of small desktop computers, such as the Apple Macintosh, the capability to generate and examine model crystal structures with a molecular graphics display program. BILAYER BUILDER stores the crystal coordinates in a Brookhaven Protein Data Bank file format for possible use in a variety of applications on many different computers. Initially, it was written for use with lipid crystals and bilayers but may be used for building an assortment of molecular crystals.

Computer Graphics↗
PubMed2005

Alcohol abuse and dependence in elderly emergency department patients.

Although elderly people are particularly vulnerable to the adverse effects of alcohol, alcohol use disorders in late life have received relatively little attention in the literature. Our objectives were to assess the prevalence of alcohol use disorders (abuse and dependence), the medical profile and psychosocial characteristics in elderly people visiting emergency department (ED). A cohort of 2405 patients aged over 60 who came to the ED of a university hospital during a 3-month period was studied. Alcohol use disorder diagnosis (DSM-IV), medical profile and social characteristics were collected from retrospective review of patient files. The data derived from 128 patients (mean age, 69.8+/-6.8 years; 87% males) with alcohol use disorders and 128 non-alcoholic controls. The prevalence of current alcohol use disorder was 5.3%. The most common current alcohol-induced disorders were alcohol intoxication and alcohol-induced mood disorder. Social factors associated with alcohol use disorders were being homeless, living alone, being divorced and never married. Falls and delirium were frequent ED admission circumstances in elderly drinkers. Drinkers more commonly presented with gastrointestinal disorders. In conclusion, alcohol use disorders among older patients admitted in ED are common and occur more frequently among men. Falls and delirium are the main ED admission circumstances in elderly drinkers. Alcohol use disorders are also associated with gastrointestinal problems.

Aged↗
PubMed2005

Ayurvedic medicine for rheumatoid arthritis: a systematic review.

OBJECTIVE: To systematically review all randomized controlled trials (RCTs) on the effectiveness of Ayurvedic medicine for rheumatoid arthritis (RA). METHODS: Computerized literature searches for all RCTs of Ayurvedic medicine for RA in the following databases: Medline (March 1969 to March 2003), Embase (February 1985 to February 2003), AMED (March 1980 to March 2003), Cochrane Controlled Trial Register (October 1997 to March 2003), and the abstract service of Central Council for Research in Ayurveda and Siddha (CCRAS; 1976 to March 2003). Hand searches were performed in 1 Sri Lankan and 3 Indian journals and the authors' personal files. Key data of included studies were extracted and reviewed. The methodological quality of all studies was evaluated with the Jadad scale. RESULTS: Seven studies met our inclusion criteria. Trials tested either Ayurvedic medicine against placebo or other Ayurvedic medicines. In general, patient and physician global assessments on the severity of pain, and morning stiffness were used as endpoints. Of 3 placebo-controlled RCTs, 1 high-quality trial did not show benefit of the active treatment against placebo, while another incompletely reported study indicated beneficial effects of an Ayurvedic medicine. A further incompletely reported study showed no significant difference. The remaining 4 trials were difficult to interpret because they tested an Ayurvedic medicine against other Ayurvedic medicines whose effects were not proven. CONCLUSION: There is a paucity of RCTs of Ayurvedic medicines for RA. The existing RCTs fail to show convincingly that such treatments are effective therapeutic options for RA.

Antirheumatic Agents↗
PubMed2003

The effect of birth weight discordance on twin neonatal mortality.

OBJECTIVE: To estimate the association between birth weight discordance and neonatal mortality controlling for the effects of fetal growth, and to understand the differences in the incidence of mortality between larger and smaller infants. METHODS: This analysis is based on the National Center for Health Statistics matched multiple birth data set file containing all twin births in the United States from 1995 through 1997. Birth weight discordance was grouped into four levels (15-19%, 20-24%, 25-29%, and 30% or more). Generalized estimating equations were used to obtain adjusted odds ratios and 95% confidence intervals to estimate the mortality risk associated with discordance after adjusting for fetal growth. RESULTS: Mortality was 11 times higher among highly discordant smaller twins (30% or more) compared with nondiscordant smaller twins (43.4 and 3.8 per 1000, respectively). Risk estimates ranged from 1.08 (95% confidence interval 0.85, 1.38) among 15-19% discordant twins to 2.05 (95% confidence interval 1.66, 2.51) among 30% or more discordant twins. Larger twins had similar risk estimates. After accounting for the association between fetal growth and discordance, mortality risk was substantially higher among smaller and larger twins who were highly discordant (30% or more). In addition, there was little difference in the magnitude of risk estimates between highly discordant smaller and larger twins. CONCLUSION: After controlling for fetal growth, smaller and larger twins affected by higher levels of birth weight discordance (25% or more) remain at disproportionate risk for neonatal mortality when compared with other smaller or larger twins. Additionally, smaller twins do not have an elevated risk compared with larger twins after adjusting for their different fetal growth distributions.

Birth Weight↗
PubMed2003

Accuracy of pharmaceutical advertisements in medical journals.

BACKGROUND: Because of the effect of the ever-growing evidence-based medicine movement on prescribing behaviour of doctors, the pharmaceutical industry incorporates bibliographical references to clinical trials that endorse their products in their advertisements. We aimed to assess whether the references about efficacy, safety, convenience, or cost of antihypertensive and lipid-lowering drugs included in advertisements supported the promotional claims. METHODS: We assessed all advertisements for antihypertensive and lipid-lowering drugs published in six Spanish medical journals in 1997 that had at least one bibliographical reference. Two pairs of investigators independently reviewed the advertisements to see whether the studies quoted to endorse the advertising messages supported the corresponding claims. FINDINGS: We identified 264 different advertisements for antihypertensive drugs and 23 different advertisements for lipid-lowering drugs. We recorded at least one reference in 31 advertisements in the antihypertensive group and at least one reference in every seven advertisements in the lipid-lowering group, providing a total of 125 promotional claims with references. We could not retrieve 23 (18%) references from monographic works and non-published data on file. 79 (63%) of the 125 references were from journals with a high impact factor; 84 (82%) of the 102 references retrieved were from randomised clinical trials. In 45 claims (44.1%; 95% CI 34.3-54.3) the promotional statement was not supported by the reference, most frequently because the slogan recommended the drug in a patient group other than that assessed in the study. INTERPRETATION: Doctors should be cautious in assessment of advertisements that claim a drug has greater efficacy, safety, or convenience, even though these claims are accompanied by bibliographical references to randomised clinical trials published in reputable medical journals and seem to be evidence-based.

Advertising↗
PubMed2000

Clinical experience with pantoprazole in gastroesophageal reflux disease.

BACKGROUND: Pantoprazole is a new proton pump inhibitor indicated for the treatment of erosive esophagitis associated with gastroesophageal reflux disease (GERD) and is available in both oral and intravenous (IV) formulations. OBJECTIVE: This paper reviews the pharmacologic properties of pantoprazole and summarizes the findings from clinical studies of this drug. METHODS: This review was compiled from the published literature, abstracts from clinical trials, and data on file with the manufacturer of pantoprazole. RESULTS: Pantoprazole selectively accumulates in the acidic environment of gastric parietal cells and acts at the final step of acid secretion by binding 2 key cysteine residues of the proton pump involved in gastric acid production. The bioavailability of pantoprazole is not altered by concomitant administration of food or antacids or with repeated dosing. Both oral and IV formulations of pantoprazole exhibit linear pharmacokinetics. Several clinical trials have proved pantoprazole superior to histamine-2-receptor antagonists (H2RAs) in reducing acid secretion and elevating gastric pH levels. Pantoprazole has been shown to be more effective than ranitidine (P < 0.05), famotidine (P < 0.001), and nizatidine (P < 0.05), and at least as effective as omeprazole, in healing erosive esophagitis and relieving associated symptoms of GERD, including regurgitation. Pantoprazole is also more effective than the H2RA nizatidine for the treatment of nighttime heartburn (P < 0.05). Studies have shown pantoprazole to be well tolerated; adverse events, including headache, diarrhea, flatulence, abdominal pain, eructation, nausea, and rash, occurred in < or = 6% of patients. The oral and IV formulations of pantoprazole are equally potent in inhibiting gastric acid secretion; thus, switching between formulations requires no dosage adjustments. Special patient populations, including the elderly and patients with renal or mild to moderate hepatic impairment, can take pantoprazole without an adjustment in dosage. CONCLUSIONS: Because of its unique pharmacokinetic properties, mechanism of action, and reduced potential for producing cytochrome P-450-based drug interactions, pantoprazole in both oral and IV formulations is effective over a full 24 hours and is well tolerated in a variety of patient types.

2-Pyridinylmethylsulfinylbenzimidazoles↗